health

As Phil Cooke put it, there’s no question that McDonald’s restaurants have enormous influence in our culture. Some sources indicate that Ronald McDonald is the most widely recognized name among small children, and when the sign says “billions served” you can count on it. That kind of influence in the culture is the Holy Grail for business leaders.

While we’re talking about Holy Grails:

Any American who has traveled more than 10 miles from their home has seen the ubiquity of McDonalds outposts with their own eyes. If ever asked to opine on the matter, I would suggest that in the U.S., there are few institutions with greater reach than Ronald McDonald.

And I would have been very, very wrong. There is a statistic provided by The Barna Group that is startling, and has sparked a fascinating theological debate (yes: Jesus and Ronald are at it again…)

According to the Barna Group research:For every McDonald’s in America, there are roughly 19 churches.

“Think about that for a moment: If there are 19 churches for every one McDonalds, why does the church today have so little influence in our culture? Obviously its not just a numbers game, but when it comes to “presence” the church should have a much greater influence.

“The comparison was very striking to me. What about you? Why does the church have so many “offices in the field,” but has so little influence in the culture?”

This is wandering deep into apples-and-oranges territory, but if we put aside our own beliefs and biases we can ponder a profound question: what does all this say about the United States and what we’ve become?

According to the British Heart Foundation, more than a quarter of teenagers make assumptions about the harm of cigarettes from the wrapping.

Heart health campaigners urged the British government Thursday to follow Australia’s lead and ban all eye-catching designs and branding from cigarette packs to stop young people being lured into smoking. Australia is preparing to become the first nation to introduce so-called “plain” packaging on tobacco products by the end of 2012. The packs will show graphic health warnings about smoking but banish attractive colors and logos.

A survey by the British Heart Foundation charity released on Thursday found that more than a quarter of young people make assumptions about the relative harm of cigarettes based on the packaging alone.

The survey, which collated responses from more than 2,700 16 to 25 year-old smokers and non-smokers, found that three quarters of those who responded thought selling cigarettes in packs with no colorful brands or logos, and larger health warnings, would make it easier for people to smoke less or quit.

One in six, or 16 percent, said they would consider the pack design when deciding which cigarettes to buy, and 12 percent said they would choose a brand because it was considered ‘cool.’

Are you one of us? The patient wanted to know, and her therapist — Marsha M. Linehan of the University of Washington, creator of a treatment used worldwide for severely suicidal people — had a ready answer.

It was the one she always used to cut the question short, whether a patient asked it hopefully, accusingly or knowingly, having glimpsed the macramé of faded burns, cuts and welts on Dr. Linehan’s arms: “You mean, have I suffered?”

“No, Marsha,” the patient replied, in an encounter last spring. “I mean one of us. Like us. Because if you were, it would give all of us so much hope.” “That did it,” said Dr. Linehan, 68, who told her story in public for the first time last week before an audience of friends, family and doctors at the Institute of Living, the Hartford clinic where she was first treated for extreme social withdrawal at age 17.

“So many people have begged me to come forward, and I just thought — well, I have to do this. I owe it to them. I cannot die a coward.” No one knows how many people with severe mental illness live what appear to be normal, successful lives, because such people are not in the habit of announcing themselves. They are too busy juggling responsibilities, paying the bills, studying, raising families — all while weathering gusts of dark emotions or delusions that would quickly overwhelm almost anyone else.

Now, an increasing number of them are risking exposure of their secret, saying that the time is right. The nation’s mental health system is a shambles, they say, criminalizing many patients and warehousing some of the most severe in nursing and group homes where they receive care from workers with minimal qualifications.

Moreover, the enduring stigma of mental illness teaches people with such a diagnosis to think of themselves as victims, snuffing out the one thing that can motivate them to find treatment: hope.

MY friend sat down and ordered a stiff drink. I didn’t think of her as the stiff-drink kind. An hour later, after our spouses drifted off into conversation, she leaned over the table. “I need your help,” she said. “My sister has a brain tumor. I don’t know what to do.”

Three years ago this month, I learned that I had a seven-inch osteosarcoma in my left femur. Put more directly: I had bone cancer. That diagnosis led me down a dark year that included nine months of chemotherapy and a 15-hour surgery to reconstruct my left leg.

At the time, my wife, Linda, and I were the parents of 3-year-old identical twin girls, and we were often overwhelmed with the everyday challenges of having a sick dad, a working mom and two preschoolers. We survived with help from many people. Our siblings organized an online casserole club, so friends could buy us dinner through a meal service. Grandparents rotated in and out of our basement. My high school classmates made a video at our reunion.

But as my friend’s query suggested, some gestures were more helpful than others, and a few were downright annoying. So at the risk of offending some well-meaning people, here are Six Things You Should Never Say to a Friend (or Relative or Colleague) Who’s Sick. And Four Things You Can Always Say.

First, the Nevers.

1. WHAT CAN I DO TO HELP? Most patients I know grow to hate this ubiquitous, if heartfelt question because it puts the burden back on them. As Doug Ulman, the chief executive of Livestrong and a three-time cancer survivor, explained: “The patient is never going to tell you. They don’t want to feel vulnerable.” Instead, just do something for the patient. And the more mundane the better, because those are the tasks that add up. Want to be really helpful? Clean out my fridge, replace my light bulbs, unpot my dead plants, change my oil.

2. MY THOUGHTS AND PRAYERS ARE WITH YOU. In my experience, some people think about you, which is nice. Others pray for you, which is equally comforting. But the majority of people who say they’re sending “thoughts and prayers” are just falling back on a mindless cliché. It’s time to retire this hackneyed expression to the final resting place of platitudes, alongside “I’m stepping down to spend more time with my family,” or “It’s not you, it’s me.”

3. DID YOU TRY THAT MANGO COLONIC I RECOMMENDED? I was stunned by the number of friends and strangers alike who inundated me with tips for miracle tonics, Chinese herbs or Swedish visualization exercises. At times, my in-box was like a Grand Ole Opry lineup of 1940s Appalachian black-magic potions. “If you put tumeric under your fingernails, and pepper on your neck, and take a grapefruit shower, you’ll feel better. It cured my Uncle Louie.”

Even worse, the recommenders follow up! Jennifer Goodman Linn, a former marketing executive who’s survived seven recurrences of a sarcoma and is compiling a book, “I Know You Mean Well, but …,” was approached recently at a store.

“You don’t know me, but you’re friends with my wife,” the man said, before asking Ms. Linn why she wasn’t wearing the kabbalah bracelet they bought her in Israel.

Like this:

The majority of Canadians say they’d be wary of disclosing any mental health issues to their bosses or unions for fear of limiting their career prospects, finds a new national report that highlights the still hobbling efforts to address mental health concerns in the workplace.

Approximately 54% of the more than 1,000 respondents surveyed by the Conference Board of Canada worry they would be passed over for a promotion if they made their bosses aware of their mental health issues. Thirty-eight per cent said such a disclosure would likely jeopardize any future leaps ahead at work — a troubling finding, considering the mounting efforts in recent years to make the workplace more supportive for those struggling with mental health concerns.

The report, released Monday, also shone a bright light on the disconnect between how well managers feel mental health issues are addressed versus the way employees see it. While 82% of managers and executives said their workplaces promoted mental health, only 30% of employees agreed.

FRIDAY, JUNE 3 — People with mental illness are more likely to die following a heart attack or serious cardiac event, a new study finds.

One explanation for this increased risk is that people with mental illness are 14 percent less likely to receive lifesaving treatments for their heart condition, researchers found.

Those treatments included coronary artery bypass graft (bypass surgery) and angioplasty (a procedure to open blocked arteries using a stent), both of which have been shown to improve outcomes for heart patients, researchers said.

The study, published June 1 in the British Journal of Psychiatry, examined 22 published studies that compared the level of care given to those with and without serious mental disorders.

“In 10 studies that specifically addressed care for people with schizophrenia, those with the disease received only half the interventions offered to those without schizophrenia,” lead researcher Alex J. Mitchell, of the University of Leicester and University Hospitals of Leicester NHS Trust, said in a news release from the university.

Six studies involving more than 800,000 people found that the risk of death was 11 percent higher in the year after a cardiac event in people with a history of serious mental illness than those without.

“People with known mental health conditions have higher background rates of cardiovascular risk factors such as smoking, inactivity and obesity. We already know that this is reflected in a higher rate of heart disease, but what we demonstrate here is that mortality is greater even after patients come under health care,” Mitchell said. “We don’t yet know the reason for these poorer outcomes but it is worrying that we also find such patients may receive less frequent lifesaving interventions.”

The study authors concluded more research is needed to determine whether patients with severe mental illness are declining treatment or whether physicians are not offering the same level of care to the mentally ill that they offer to their patients without mental disorders.